Prevention of mother-to-child HIV transmission needs to involve men

A new plan in to end mother-to-child transmission (PMTCT) in Ethiopia by 2015 is seeking to involve male partners in reproductive health to better reduce risk.

Studies on the subject have shown that a low level of involvement by male partners is one of the biggest challenges to effective PMTCT programmes.

Health experts in Ethiopia have emphasized the fact that men’s increased involvement in PMCTC has a positive impact on prevention of mother-to-child HIV transmission due to the fact that they encourage their partners to visit antenatal clinics and used skilled birth attendents.

A 2010 Kenyan study found that male partner involvement in PMTCT reduced the risks of vertical transmission and infant mortality by more than 40 percent compared to no involvement.

A health care worker at the Gandhi Memorial Hospital in Ethiopia stated that "Among the pregnant women who come to our hospital, less than 10 percent of them come with their partners. Those who find out that they are living with the virus usually face a problem while taking medicines, given that most prefer to take it without the knowledge of their partners."

Another health care worker from the Zewditu Hospital antireviral service centre in Addis Ababa stated that "The biggest challenge we are currently facing is to convince mothers to get tested in order to determine that they are eligible for PMTCT services... the major reason for their resistance is lack of consent from their husbands or partners, who are more influential in family matters including this."

It was found that when women did learn of their status, their reluctance to have their status known by their male partners impacted the way they used services and the effectiveness of those services.

To counteract this reluctance, Ethiopia launched the national accelerated emergency PMTCT plan with three objectives: reaching 90 percent of pregnant women with access to antenatal care services; ensuring universal access by pregnant women to a skilled attendant during delivery; and providing ARVs to at least 80 percent of HIV-positive pregnant women.

It has been estimated that 1.2 million Ethiopians are living with HIV, including about 90,000 pregnant women; just 9.3 percent of pregnant women who are eligible for HIV services are currently receiving them.

The number of Ethiopian mothers receiving HIV testing as part of PMTCT services has grown to over 70 percent, but just 6 percent of births are attended by a skilled health worker, according to the UN World Health Organization.

Tadesse Ketema, a maternal health adviser at the Ministry of Health, stated that "Through the health extension programme, the country manages to create easy access for family planning services for many families and that has worked so far. We are now planning to copy that in the PMTCT programme to reach out [to] each pregnant woman and give the service at their convenience."

The Ethiopian government intends to use "health development armies" - community groups mobilized to further government health programmes - to create demand and convince the community, including male partners, to benefit from nearby PMTCT services.